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. Author manuscript; available in PMC: 2016 May 16.
Published in final edited form as: AJR Am J Roentgenol. 2012 Jan;198(1):162–172. doi: 10.2214/AJR.11.6505

Figure 5.

Figure 5

25-year-old woman with Ewing sarcoma of left sacrum.

A, Axial T1-weighted spin-echo MR image (TR/TE, 690/15) shows left sacral mass as low-signal-intensity lesion at sacroiliac joint.

B, Axial fat-suppressed fast spin-echo T2-weighted MR image (TR/TE, 2886/100) shows involvement of neural foramina, crossing of sacroiliac joint, and associated soft-tissue component in anterior aspect. Although conventional MRI findings suggested malignant features, diagnosis of giant cell tumor was entertained in light of some characteristic features.

C, Single-voxel proton MR spectroscopic map obtained within sacral mass with weak water suppression (top left) shows discrete choline peak (arrow). Relative signal-to-noise ratio is 3.6. Absolute choline concentration was calculated to be 2.9 mmol/kg, suggesting malignancy in this pathologically proven Ewing sarcoma. Upper right image is not water suppressed.